This study aimed to examine anatomical factors predicting anterior ethmoidal artery type.

Paranasal sinus computed tomography images from adult patients were reviewed. Anterior ethmoidal artery types were categorised based on skull base relationship: type A (embedded within skull base), type B (in a protruding canal) and type C (separated from skull base). Statistical analyses encompassed inter-type comparisons, multinomial logistic regression and correlation analysis.

Anterior ethmoidal artery types differed significantly in lateral lamella height and Keros classification, with type C showing the greatest lateral lamella height and predominant Keros III. Type C was additionally characterised by enlarged frontal sinus volume, increased volume and height of frontal recess anterior cells and higher supraorbital ethmoid cell prevalence. The anterior ethmoidal artery–skull base distance demonstrated significantly positive correlations with lateral lamella height, frontal sinus volume and the volume and height of frontal recess anterior cells.

More extensive pneumatisation of frontal sinus and ethmoid cells and increased lateral lamella height might predict a free-running anterior ethmoidal artery.

Paediatric septoplasty remains a contentious topic due to concerns about its potential impact on midfacial growth and the landscape in the UK has been largely unexplored to date. We aimed to describe the current attitudes and practice patterns surrounding paediatric septoplasty practice in the UK.

A survey was distributed to independently practising ENT surgeons across the UK. Statistical analysis and qualitative thematic analysis were performed.

A total of 103 responses from all UK regions were analysed. Opinions on septoplasty in children were polarised. Rhinologists, as well as consultants with more than 10 years’ experience, were more likely to offer surgery. Qualitative thematic analysis identified six themes within free-text responses, reflecting the diversity of current practice.

Paediatric septoplasty is being offered in the UK, but attitudes remain divided and practice is highly variable. Prospective longitudinal studies are needed to clarify long-term outcomes.

This study compared endoscopic butterfly inlay and microscopic over-underlay cartilage tympanoplasty regarding graft success and hearing outcomes.

A retrospective analysis was performed on patients who underwent tympanoplasty between January 2022 and December 2024. Patients with additional otologic procedures, cholesteatoma or revision surgery were excluded. Patients were assigned to Group 1 (endoscopic butterfly inlay) or Group 2 (microscopic over-underlay). Demographic characteristics, perforation size, operative time, graft success and audiometric outcomes were evaluated using air–bone gap (ABG).

Sixty-four patients were included (33 in Group 1, 31 in Group 2). Operative time was significantly longer in the microscopic group, while perforation size and graft success rates were similar. Both techniques resulted in significant post-operative hearing improvement without inter-group differences.

Both techniques provided comparable graft success and hearing outcomes. The endoscopic butterfly inlay technique achieved similar results with shorter operative time, supporting its use as a minimally invasive alternative.

Malignant otitis externa is a life-threatening infection in which facial nerve palsy is a morbid complication. This TriNetX study identified predictors of facial nerve palsy in malignant otitis externa.

Retrospective analysis compared malignant otitis externa-only (n = 12 032) versus malignant otitis externa plus facial nerve palsy (n = 719) cohorts for demographics, biochemical markers and co-morbidities using t-tests and odds ratios (p < 0.05).

Male gender (p = 4.65 × 10−15) and Hispanic and/or Latino ethnicity (17.66 vs 13.02 per cent, p = 0.0014) predicted facial nerve palsy. The significant biochemical markers were albumin, blood urea nitrogen (p < 10−18), glucose, erythrocyte sedimentation rate (ESR), creatinine, iron and activated partial thromboplastin time. The key co-morbidities were hypertension (odds ratio = 3.72, p = 6.95 × 10−55), chronic kidney disease (odds ratio = 3.12, p = 1.44 × 10−49), malnutrition (odds ratio = 3.44) and electrolyte imbalances (odds ratio = 2.59). Migraines and/or headaches were non-significant.

Male sex, Hispanic and/or Latino ethnicity, hypoalbuminemia, elevated blood urea nitrogen and/or glucose and/or ESR, and co-morbidities (hypertension, chronic kidney disease, malnutrition) strongly predict facial nerve palsy in malignant otitis externa. Early risk factor management may prevent facial nerve palsy.

To evaluate the efficacy differences of house dust mite sublingual immunotherapy in allergic rhinitis patients of different ages.

Ninety-two patients who underwent 1 year of house dust mite sublingual immunotherapy were retrospectively analysed and divided into groups of children (<14 years, n = 46) and adolescents and adults (≥14 years, n = 46). The total nasal symptoms, total medication, combined symptom and medication, and mini Rhinoconjunctivitis Quality of Life Questionnaire scores were assessed.

Significant improvements were displayed after sublingual immunotherapy treatment compared with baseline (p < 0.001). In particular, children exhibited more pronounced improvements on each indicator than adolescents and adults at the end of 1 year of sublingual immunotherapy treatment (p < 0.05). Meanwhile, correlation analysis revealed that the mini Rhinoconjunctivitis Quality of Life Questionnaire score has positive correlations with the total nasal symptoms, total medication, and combined symptom and medication scores (all p < 0.001).

More notable improvements were seen in children than in adolescents and adults with allergic rhinitis after one year of house dust mite sublingual immunotherapy treatment.

This study examined the temporal and seasonal distribution of sudden sensorineural hearing loss admissions and audiogram types from 2015 to 2024 using seasonal-trend decomposition with locally estimated scatterplot smoothing.

A retrospective analysis included sudden sensorineural hearing loss patients admitted to a tertiary otorhinolaryngology clinic between January 2015 and December 2024. Demographics, admission dates and audiogram types were evaluated.

Among 738 patients (mean age 45.7 ± 15.6 years; 58.4% male), admissions varied significantly across years, months and seasons, peaking from November to March. Winter admissions were highest, while autumn had the lowest. Seasonal-trend decomposition with locally estimated scatterplot smoothing confirmed recurring seasonal patterns. Although audiogram types showed no seasonal or pandemic association, their distribution differed significantly by month.

Sudden sensorineural hearing loss admissions demonstrate clear temporal and seasonal clustering, aligning with influenza-like illness peaks and suggesting a viral contribution. Monthly audiogram variations imply possible environmental influences.

This study describes the management and outcomes of temporal bone fractures resulting from falls.

We retrospectively reviewed patients with traumatic temporal bone fractures from 2018 through 2022.

We analysed 171 patients with temporal bone fractures, 62 (36.3 per cent) of which occurred secondary to falls. Fall patients were significantly older than non-fall patients (mean age 46 vs. 38 years; p = 0.0079) and had higher Modified Frailty Index-5 scores (0.63 vs. 0.20; p = 0.0003). Fall patients had shorter hospital stays (10.1 vs. 15.8 days; p = 0.015), were more frequently discharged home (66.1 vs. 44.0 per cent; p = 0.007) and were less likely to experience non-resolving facial nerve weakness (6.5 vs. 21.1 per cent; p = 0.030).

Patients with temporal bone fractures from falls are older and frailer than non-fall patients and have unique preventative and rehabilitation needs.

This study aimed to explore the efficacy of tramadol for neurogenic cough and describe the longitudinal treatment experience.

A retrospective case series of adults with chronic cough who were treated with tramadol for neurogenic cough. A complete response was defined as no pathologic coughing, and a partial response was defined as 50 per cent or greater reduction in severity or frequency.

Sixty-nine patients were included: 38 per cent of patients reported a complete response with an additional 33 per cent reporting a partial response. The most common successful dosing regimen was 50 mg twice a day. Age, gender and body mass index did not impact treatment response. Patients with a history of laryngeal surgery were less likely to respond (p = 0.04). Sedation (10 per cent) was the most common side effect. Fifty per cent of complete responders (n = 13) were weaned off tramadol after a mean of 39 weeks of treatment.

Tramadol may be effective and is well tolerated in patients with neurogenic cough.

To map the scope, methods and focus areas of qualitative research in paediatric otolaryngology.

A Preferred Reporting Items for Systematic Reviews and Meta-Analyses-compliant systematic mapping review searched MEDLINE, Embase, CENTRAL and PsycInfo (August 2025) for qualitative or mixed-methods studies with a qualitative component related to paediatric otolaryngology. Two reviewers independently applied the inclusion criteria. Key study characteristics were extracted; no formal risk-of-bias assessment was performed, in line with the aims of a mapping review.

Eighty-nine studies were included. Publications rose sharply after 2015, with nearly three-quarters from the USA, Canada and the UK. Otology (49 per cent) and laryngology (40 per cent) predominated; common topics were hearing loss, tonsillectomy and tracheostomy. Interviews, mainly semi-structured (73 per cent), were the dominant method, and caregivers were the most frequent participants (62 per cent).

Qualitative research in paediatric otolaryngology is growing but remains geographically and methodologically narrow. Broader stakeholder inclusion and methodological diversity are needed to deepen understanding and support patient-centred care.

The specialties of ENT and anaesthesia have always had a unique relationship because of their longstanding history of co-operation over the shared airway.

This historical review narrates how the modern practice of ENT surgery has developed following advances in anaesthetic techniques, as well as inspiring them.

From the earliest use of anaesthetic gases by Long, Wells and Morton, to their rapid adoption for use in tonsil and cleft palate surgical procedures, ENT surgeons were early beneficiaries of this new technology. The demands of surgery for facial injuries in World War II was a driver for anaesthetic advances, and Ivan Magill reinvented the specialty in response.

Further developments in managing the shared airway, including jet ventilation, total intravenous anaesthesia and awake fibre-optic intubation, have shaped the modern ENT operating theatre, and highlight the vital collaboration between ENT and anaesthesia over the past 150 years.

High-risk cutaneous squamous cell carcinoma represents 3–5 per cent of all cutaneous squamous cell carcinomas but causes most disease-specific deaths. Head and neck tumours are often high risk. Recent phase-3 trials have challenged surgery plus or minus radiotherapy as standards of care. This review updates definitions and evidence on emerging treatments.

Narrative review.

High-risk cutaneous squamous cell carcinoma is defined by size greater than 2 cm, deep invasion, poor differentiation, perineural/lymphovascular invasion, nodal spread or immunosuppression. Surgery remains central, with adjuvant radiotherapy improving locoregional control. The KEYNOTE-630 trial of adjuvant pembrolizumab showed a non-significant recurrence-free survival gain (hazard ratio 0.76), with benefit in elderly and extracapsular extension subgroups. The C-POST trial established adjuvant cemiplimab as the first systemic therapy significantly improving disease-free survival (hazard ratio 0.32; 24-month disease-free survival 87 per cent vs 64 per cent). Emerging strategies include neoadjuvant programmed cell-death protein 1 blockade, circulating tumour DNA-guided monitoring and combinations.

Cemiplimab redefines the post-operative standard; pembrolizumab awaits confirmation. Future directions include earlier immunotherapy, biomarker validation and access expansion.

Pierre Robin Sequence is characterised by a small lower jaw, tongue displacement and, often, a U-shaped cleft palate, leading to breathing and feeding problems. Orthodontic airway plates have been developed as a non-invasive treatment option. A systematic review was conducted to evaluate the outcomes of orthodontic airway plates in children with Pierre Robin Sequence.

Databases were searched for studies published up to December 2024, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Ten clinical studies with a total of 598 patients were included, among which 483 had isolated Pierre Robin Sequence, and 115 had syndromic Pierre Robin Sequence. Orthodontic airway plates improved airway obstruction and helped avoid tracheostomy in most patients. A small proportion of syndromic cases still required surgery. Feeding outcomes improved, with fewer children needing tube feeding. Speech development was good, though hypernasality persisted in some.

Orthodontic airway plates are a minimally invasive yet effective way to manage airway complications in Pierre Robin Sequence patients.

To evaluate the effectiveness and safety of endoscopic interventions for managing paediatric subglottic stenosis.

Following Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines and the Cochrane Handbook, we systematically searched four databases from inception to August 2024. Studies reporting outcomes of endoscopic management of paediatric subglottic stenosis were included. The primary outcome was procedural success; secondary outcomes were recurrence, decannulation and complications.

Forty-three studies involving 1088 children were included. The pooled success rate of endoscopic treatment was 79.2 per cent. Carbon dioxide and potassium titanyl phosphate laser achieved success rates of 79.9 and 100 per cent, respectively. Balloon dilatation and rigid dilatation had success rates of 79.9 and 82.4 per cent, whereas cold knife alone had a lower rate of 47.2 per cent. The recurrence rate was 36.8 per cent and balloon dilatation showed the highest recurrence at 42.2 per cent. The pooled decannulation rate was 60.4 per cent and complications occurred in 3.0 per cent of cases.

Endoscopic interventions are effective for paediatric subglottic stenosis, but recurrence remains common.